Hu Bin, Zhu Yiyao, Wu Xiaobo
Department of Thoracic Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
J Gastrointest Oncol. 2022 Apr;13(2):527-538. doi: 10.21037/jgo-22-145.
Esophageal cancer is a highly aggressive, early metastasis gastrointestinal malignancy, with geographic differences in prognosis. It is unknown whether there are differences in the survival in different regions among esophageal cancer patients who underwent the treatments. This study was to explore the influencing factors of esophageal cancer survival in patients from China and the Surveillance, Epidemiology, and End Results (SEER) database.
The retrospective cohort study were conducted with 605 Chinese esophageal cancer patients in the Wuxi People's Hospital and 2,351 patients from the SEER database. The demographic and clinical data were collected from the two cohort, respectively. The outcome was the death during the follow-up. The follow-up ended on November 30, 2021. The Cox proportional hazards model was used in the univariate and multivariate survival analyses, with hazard ratio (HR) and 95% confidence interval (CI).
In group one, the following were identified as the prognostic factors: female gender (HR =0.568; 95% CI: 0.398-0.811), T3 and T4 stages (HR =3.312; 95% CI: 2.493-4.401), N2 and N3 stages (HR =3.562; 95% CI: 2.631-4.824), and other subtypes of cancer (HR =0.393; 95% CI: 0.223-0.693). The following prognostic were factors identified in group two: age ≥65 years (HR =1.16; 95% CI: 1.058-1.276), female gender (HR =0.843; 95% CI: 0.752-0.945), T3 and T4 stages (HR =1.523; 95% CI: 1.373-1.690), M1 stage (HR =2.554; 95% CI: 2.303-2.832), treatment with surgery and chemotherapy (HR =0.507; 95% CI: 0.457-0.562), and other subtypes of cancer (HR =1.432; 95% CI: 1.298-1.581).
There may be some differences in prognostic factors between Chinese and American patients with esophageal cancer. It is indicated that different management strategies of esophageal cancer should be considered in different populations to improve the prognosis of patients.
食管癌是一种侵袭性很强、早期易转移的胃肠道恶性肿瘤，预后存在地域差异。对于接受治疗的食管癌患者，不同地区的生存率是否存在差异尚不清楚。本研究旨在探讨来自中国的食管癌患者以及监测、流行病学和最终结果（SEER）数据库中患者食管癌生存的影响因素。
对无锡市人民医院的605例中国食管癌患者和SEER数据库中的2351例患者进行回顾性队列研究。分别从两个队列中收集人口统计学和临床数据。观察结果为随访期间的死亡情况。随访于2021年11月30日结束。在单因素和多因素生存分析中使用Cox比例风险模型，计算风险比（HR）和95%置信区间（CI）。
在第一组中，确定的预后因素如下：女性（HR =0.568；95%CI：0.398 - 0.811）、T3和T4期（HR =3.312；95%CI：2.493 - 4.401）、N2和N3期（HR =3.562；95%CI：2.631 - 4.824）以及其他癌症亚型（HR =0.393；95%CI：0.223 - 0.693）。在第二组中确定的预后因素如下：年龄≥65岁（HR =1.16；95%CI：1.058 - 1.276）、女性（HR =0.843；95%CI：0.752 - 0.945）、T3和T4期（HR =1.523；95%CI：1.373 - 1.690）、M1期（HR =2.554；95%CI：2.303 - 2.832）、接受手术和化疗（HR =0.507；95%CI：0.457 - 0.562）以及其他癌症亚型（HR =1.432；95%CI：1.298 - 1.581）。
中国和美国食管癌患者的预后因素可能存在一些差异。这表明应针对不同人群考虑不同的食管癌管理策略，以改善患者的预后。
